The UK population is ageing steadily, with over-65s projected to make up a quarter of the population by 2050. As demand on health and social care grows, the 10 Year Health Plan for England calls for a shift from hospitals to the community and from treatment to prevention. The question is, what does this shift look like in practice – especially at the point where people move from acute care back into daily life?
CQC’s State of Care highlights the need for more person-centred care, with better communication, co-ordination and collaboration across services. It acknowledges pressure at transition points, where people often fall through gaps. In reablement, this transition from structured support to independence is where partnership working becomes vital.
For many people, reablement achieves what it is designed to do. In our experience, most individuals return to their baseline and leave care fully independent, with around three quarters not requiring any ongoing formal care. However, even when formal support is no longer needed, some people still benefit from light-touch help to reconnect with their community. Without this, the move from structured reablement back into everyday life can feel abrupt for those without strong support networks, which is where better integration with community services becomes essential.
Embedding voluntary and third sector partners into local authority-funded reablement can provide the wrap-around support to prevent escalation. This approach not only delivers the shift from hospital to community but also strengthens prevention by ensuring people have the right support to stay well.
Since 2017, ECL has commissioned Castle Point Association of Voluntary Services (CAVS) to work alongside our reablement team as Information and Advice Co-ordinators (IACs). This support is provided in addition to the work of our care teams. Crucially, it helps people to navigate a smoother transition once ECL’s reablement package ends, by connecting them with longer term sources of support within their community.
CAVS bridges the gap between funded care and longer term independence. The IACs connect people with community groups, social opportunities and wider support that would otherwise be hard to access. They also help people secure benefits they are entitled to which can be used to pay for additional support. These practical steps allow people to remain at home for longer and contribute to improved wellbeing, mobility and confidence.
This is not simply additional help; it is a strategic investment in a more sustainable system. In 2024 to 2025, ECL invested £65k to commission the integrated support of the IACs. As a result, 449 people were supported while still completing their reablement journey to access a combined £2.5m of annual Attendance Allowance income. This investment has contributed to reduced hospital admissions, fewer referrals to temporary residential care and reduced reliance on domiciliary care. The financial benefit flows back into the local economy while supporting better outcomes for individuals.
Our experience shows the value of true partnership working. It demonstrates how reablement and the voluntary sector can together deliver a model that meets both physical rehabilitation needs and wider wellbeing needs. The challenge now lies in securing a sustainable funding framework so that this approach can grow and be replicated.
Our ambition is to strengthen these partnerships further across Essex. We will continue to work with commissioners and community partners to explore creative and sustainable ways to support people beyond the end of their therapy-led care package. We already deliver a high-quality service with Acute Facilitators based in hospitals to support a safe and confident transition home. The CAVS partnership extends that transition into the community and helps people stay independent for longer.
In my view, this represents an ideal model of care. It brings together physical reablement, community connection and preventative support in a way that reflects the realities of people’s lives. With the right funding model, this type of approach could be central to achieving the shift from hospital to community and from treatment to prevention.
What do you think the ideal model of care should look like? Comment on this column or join the conversation to share your thoughts.
Charlene Adutwim is a Regional Business Manager at Essex Cares Ltd. Email: [email protected] LinkedIn: @Charlene-Adutwim